Global Health at the DLSPH

March 25/2014

Dear DLSPH Faculty,

I am writing to clarify issues related to global health at the DLSPH and provide an update on what lies ahead. I apologize in advance for the length of this communication. I hope you will bear with me as I try to clear up some confusion as we sundown the Division of Global Health.

First, I’d like to re-confirm the commitment of the DLSPH to global health as one of its highest priorities.  It remains one of the three over-arching strategic directions of the School as well as an area in which so many of you excel and continue to make extra-ordinary contributions in terms of research, analysis, teaching, training, policy-formation and service.

Second, I’d like to acknowledge that despite these promising attributes, advancing the DLSPH global health agenda has been slow and challenging.  Part of this has been related to the pace of development of the School as a whole—although we became a stand-alone Faculty last July, building the administrative infrastructure that is critical to expanding the School’s programs remains a work-in-progress, with, for example, the search for our first Associate Dean for Research still in progress and the arrival of our first Director of Advancement (Beth McCarthy—an outstanding hire) still to come (on March 31).  Both of these positions are key to building the institutional tools we need to get “to the next level” on all of our initiatives, including global health.

But part of this has also been due to a combination of the very complex landscape that pertains to global health at the University of Toronto as well as starts and stops in global health leadership at the DLSPH over the years.  I was not fully aware of this history when I came to DLSPH, and thus have made several decisions that may not have taken into account all of the data necessary to ensure a complete picture of the School’s global health needs. For this, I take full responsibility and acknowledge that much of what has (or has not) happened in the last year could have been done better.

Over the last six months, I have taken a step back to gather advice from numerous global health stakeholders and thinkers at DLSPH and further afield, and I believe that we are ready to forge ahead with a plan that will not only meet the core needs of DLSPH faculty and students, but provide synergies for global health stakeholders at UofT, beyond the University and across the world.  With that in mind, I am writing to provide you with an update of where we are and where we are heading, and from my perspective, with a greater commitment to process and transparency.

Organization of Global Health at the DLSPH

The future of organized global health at the DLSPH will be determined by three structures: (A) a new Office for Global Health Education and Training at DLPSH; (B) the Institute for Global Health Equity & Innovation (IGHEI); and (C) the DLSPH Divisions.

A.   The Office of Global Health Education and Training

  • This Office will fill the gap that many of you have noted exists at DLSPH. It will serve several of the functions that had been previously performed by the Division of Global Health and will expand this mandate to include the following
  • Serve as the home of the Masters Global Public Health Emphasis Program, which in turn will become a Diploma or Certificate program in global health to better meet the interests of our students.
  • Oversee the administration and development of both local and international global health practicum sites, associated Memoranda of Understanding, and the preparation and supervision of students working in foreign countries.
  • Administer student exchange programs between the DLSPH and global partners.
  • Create and manage long-distance education and training programs on key global health topics with global partners.
  • Administer the application and processing of Visiting Scholars from global partners.
  • Serve as a “clearinghouse” for information on global health seminars and other activities of particular interest to DLSPH students.
  • Oversee a mapping exercise that will illustrate where DLSPH faculty are working (or have worked) in the world. This information will be housed on the DLSPH website.

B.   Institute for Global Health Equity and Innovation (IGHEI)

IGHEI remains a University-wide EDU-C with terrific potential to be an entity that resonates with many of our global health stakeholders within the University and beyond. Formed in 2012, its vision is:

“…to engage in complex global health equity problemsolving [through research and training] that could not otherwise be successfully addressed by a single discipline or research group. The

anticipated outcomes are to provide innovative solutions with potential major global societal impact and to build capacity in this field. The participating collaborating university Divisions are: the Faculty of Medicine, including the Dalla Lana School of Public Health and the Joint Centre for Bioethics; the Faculty of Arts & Science including the Munk School of Global Affairs; the Rotman School of Management; and the Faculty of Applied Science and Engineering Centre for Global Engineering. This unit will include close collaboration with centres of excellence in global health within the hospitals fully affiliated with the University of Toronto. The core faculty members of this new EDUC will be crossappointed from their primary University Departments.

However, the process to create IGHEI did not take into account the interests and expertise of many UofT global health stakeholders, and it didn’t provide a clear path of how to attain its vision or the resources to build such a vision.  For example, outside of serving as a connector of faculty with PhD and Masters students interested in global health, the value-added proposition of IGHEI in relation to the other centres of global health at the University, Hospitals and further afield remains unclear.  What is clear is that defining the specific value-added potential of IGHEI requires a strategic process in itself.

It is with this in mind that I agreed to support a Global Health Summit  “Creating a Pandemic of Health”, planned for November 3-5 2014, to bring faculty with global health interests at DLSPH, UofT and international colleagues together to help refine the identity of IGHEI and draft a roadmap for action. The Summit organizers, Rani Kotha, Alex Jadad, Abdallah Daar, and Ross Upshur, have met with hundreds of GH stakeholders at the UofT and beyond to formulate the sub-themes of the Summit. The subthemes have been crafted with an eye towards building on the unique strengths of UofT and capitalizing on the strengths of the DLSPH-affiliated faculty. This process has already yielded greater clarity on potential directions for IGHEI while also creating the conditions for a truly transformative event. The subthemes are as follows:

  • Creating and spreading health: What would it take to promote full happy lives from the first to the last breath, for all?
  • Power, privilege and politics: what really determines global health inequities?
  • Preventing the preventable, treating the treatable, transcending the inevitable: What is the gold standard for health systems?
  • Health, urbanization and the growth of megacities: When is more more?
  • Achieving convergence: What kind of life should future generations experience?
  • Global big data: Enslaving or liberating – how do we redefine the value proposition to focus on the faces behind the numbers?

C.   The Divisions

Here, we mean the Divisions of Epidemiology, Biostatistics, Social & Behavioural Health Sciences, Occupational & Environmental Health, Clinical Public Health and Public Health Policy (soon to be replaced by the Institute for Health Policy, Management & Evaluation).  IHPME and each of these Divisions will work with the Office of Global Health to develop Global Health programming that meets the aspirations of their students for global health training and experiences.

Next Steps

  1. As noted above, given the gaps that currently exist at DLSPH vis-à-vis global health administrative infrastructure for our Masters and Doctoral students, we are creating a new Office of Global Health Education and Training. This office will be led by Arun Chockalingam, Professor of Epidemiology and Global Health. The first task will be to provide a broad assessment of the needs of DLSPH students vis-à-vis global health (taking into account what is being done at peer Schools of Public Health in Canada and internationally), how to maximize the limited resources in global health in service of our students, which faculty can be recruited to work on various aspects of the Office’s programs etc.  This Office will also serve as the home for the current “Global Health Fellows” seminar program, which was originally billed as a product of IGHEI.  However, although it serves the need for Global Health training for current post-doctoral fellows at the DLSPH, it is not intended to be the innovative Fellows program that IGHEI intends to launch next year (and about which many of you had participated in the brain-storming planning session that occurred last summer).  These programs will likely be combined to provide a single broadly based seminar that we hope will resonate with all of our global health fellows and doctoral students.

  2. As noted above, the Global Health Summit will take place from November 3-5, 2014 at MaRS. We are indeed fortunate that MaRS has donated the space for the Summit including an auditoria space that will hold 325+ people, and 5-6 breakout rooms. All members of the DLSPH global health faculty community will be invited to register and attend the Summit (registration is free but will be required). In order to ensure wide attendance and participation, the Summit will be web-cast, and the knowledge and insights generated by the Summit will be captured, disseminated and enhanced through innovative means, such as real-time visualization strategies, interactive videos and crowdsourcing approaches.

  3. Many of you have provided critical strategic feedback on the Collaborative Doctoral Program in Global Health, which has underscored the strategic value of ensuring continued strong leadership for this program. I will be meeting with the Collaborative Program’s Steering Committee in the coming weeks to share some of this feedback and discuss the Committee’s thoughts on the current and future direction of the program. As the current Director of the Program, Donald Cole, will be on a year-long sabbatical beginning July 1, 2014, the issue of leadership for the program will be a topic of conversation with the Steering Committee. In addition, there needs to be a discussion about resourcing the Program to ensure that we are attracting more applicants from a variety of disciplines to expand the program.

  4. As I hope you will have noticed, we have launched the search for the next occupant of the Dalla Lana Chair in Global Health that was vacated with the departure of James Orbinski.  We aim to recruit a world-leading scholar to occupy this important position who will engage broadly with colleagues here and elsewhere. The launch of the search for the permanent Director for IGHEI has been delayed until after the Global Health Summit.

  5. Finally, I’d like to alert you to the planned creation of a “Big Ideas” undergraduate course entitled “Grand Opportunities in Global Health” that is being developed by Abdallah Daar and colleagues.  With a launch targeted for January of 2015, this course will involve many of you and will likely serve as a gateway to the new undergraduate program in global and public health that DLSPH is creating in collaboration with the Provost’s Office and colleagues in Arts & Sciences.

I hope this communication helps to clarify the status and plans for global health at DLSPH.  As always,  feel free to communicate with me directly with your ideas and suggestions.

Sincerely,

Howard Hu

Dean

Acting Director, IGHEI